Practice Quiz

CSC Cardiac Nursing Subspecialty

Category - Problems

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Which of the following surgical corrections is not correctly matched with the type of surgery performed to correct the type of aortic stenosis?
  1. Supravalvular aortic stenosis - myectomy of hypertrophied ventricular septum
  2. Supravalvular aortic stenosis - patch augmentation of ascending aorta
  3. Subaortic stenosis - resection of fibrous membrane
  4. Valvular aortic stenosis - percutaneous balloon valvotomy or valve replacement
Explanation
Answer: A - Aortic stenosis is not corrected by myectomy.
• may occur at 3 levels: subaortic (fibrous membrane or tunnel stenosis), valvar (unicuspid or fusion bicuspid valve), or supravalvar (fibrous ridge or hypoplasia of ascending aorta)
• indications for surgery: infants with critical aortic stenosis (severe low output states, cyanosis by right-to-left ductal shunting), older children with symptoms or peak gradient > 50 mmHg
Surgical procedures
• subaortic stenosis relieved by resection of fibrous membrane or myectomy of hypertrophied ventricular septum
• valvular aortic stenosis relieved by percutaneous balloon valvotomy or valve replacement
• supravalvular aortic stenosis relieved by patch augmentation of ascending aorta
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